Rule Emission: A Possible Variable for Improved Therapeutic Practice

Span J Psychol. 2018 Oct 25:21:E38. doi: 10.1017/sjp.2018.42.

Abstract

It has been suggested that achieving greater effectiveness in psychotherapeutic treatment requires analyzing what therapists actually do and say, how they do this and when it is done. Based on this approach, in this study we focused on the rules emitted by therapists, since providing rules is thought to be of fundamental importance in promoting effective and efficient clinical change. Specifically, we sought to determine whether the experience level of therapists and the brevity of therapy would be related to patterns of therapist rule emission as categorized by the Category System of Rules emitted by the Therapist (SISC-RULES-T) (Vargas-de la Cruz & Pardo-Cebrián, 2014). Greater therapist experience and shorter therapy duration were found to be reliably predictive of more rule emissions across most rule categories (Z values between: Z = -3.68 and Z = -2.05; p values: p < .05 and p < .001). These variables were also predictive of more emissions of rules that specified all three operant contingency elements (situation, behavior, and consequence) rather than fewer elements (Z = -2.59, p < .05; Z = -2.26, p < .05). In the expert therapists and therapist with shorter cases, there was a nonsignificant tendency for the emission of general and conceptual rules to increase over sessions whereas emissions of concrete and particular rules tended to decrease; the explicitness of the three contingency elements also tended to decrease as treatment progressed. These findings may help to identify verbal characteristics of therapists that could lead to improved therapeutic practice.

Keywords: effectiveness; rules; therapeutic process; therapist; verbal behavior.

MeSH terms

  • Adult
  • Clinical Competence*
  • Humans
  • Process Assessment, Health Care*
  • Professional-Patient Relations*
  • Psychotherapeutic Processes*
  • Psychotherapy / methods*
  • Psychotherapy / standards
  • Verbal Behavior*